Slow-release tramadol for treatment of chronic malignant pain--an open multicenter trial.

Abstract

Patients with moderate to severe cancer pain and insufficient pain relief from nonopioid analgesics were treated with slow-release tramadol for initial dose finding and as a long-term treatment. Immediate-release tramadol was provided for the treatment of breakthrough pain and a standard nonopioid analgesic (1000 mg naproxen daily) was given as suggested for step 2 of the WHO analgesic ladder. Ninety of 146 patients (62%) completed the 6-week trial period. Drop-outs were due to adverse events (20%), inadequate pain relief (9%), or both (2.5%), death due to the underlying disease (4%), low patient compliance (2%) or other reasons. Average and maximal pain intensity decreased from day 1 to day 4. The number of patients with good and complete pain relief increased from 43% after week 1 to 71% after week 6 with maximum daily doses of tramadol up to 650 mg. However, 70% of the patients still needed less than 400 mg tramadol per day in week 6. Most patients (86%) experienced adverse events during the study period. Some common side effects of opioids, such as fatigue, dizziness, and constipation, decreased in frequency over the 6 weeks. The frequency of other adverse events such as nausea, vomiting and sweating did not change. Slow-release tramadol provided fast and efficient pain relief in almost two-thirds of patients both during initial dose finding and during long-term treatment, improving treatment options in step 2 of the WHO analgesic ladder.

• Authors: F Petzke, L Radbruch, R Sabatowski, M Karthaus, A Mertens
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 9 Issue 1 Pg. 48-54 (Jan 2001) ISSN: 0941-4355 [Print] Germany
• PMID: 11147143 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Opioid
• Delayed-Action Preparations
• Tramadol

Topics

• Adult
• Aged
• Analgesics, Opioid (administration & dosage, adverse effects, pharmacology)
• Chronic Disease
• Delayed-Action Preparations
• Female
• Humans
• Male
• Middle Aged
• Neoplasms (complications)
• Pain (drug therapy, etiology)
• Tramadol (administration & dosage, adverse effects, pharmacology)
• Treatment Outcome